Method for non-invasive pressure determination in lower cavopulmonary link in children with functionally single ventricle after total cavopulmonary link surgery
SUBSTANCE: peak linear speed of blood flow in the hepatic vein is determined in pulse-wave mode on exhalation (HV1) and inhalation (HV2), at a distance of 3-5 cm from hepatic vein confluence into the lower hollow vein. To do this, an ultrasonic system with a convex sensor is used, the control volume of which is 1/3 of the diameter of the middle hepatic vein, and the pressure value in the lower cavopulmonary link is determined by the original formula.
EFFECT: method allows non-invasive monitoring of the pressure index in the lower cavopulmonary link in dynamics without additional preparation.
SUBSTANCE: technique involves foetus's middle cerebral artery Doppler ultrasonography prior to and after a pregnant woman holds her breath as much as possible at a depth of inhale. Diagnostically significant indices of blood velocity curves resistance in the foetus's middle cerebral artery that are a systolic/diastolic ratio, a resistance, a pulsation index are measured with a breath-holding test conducted and taking into account foetus's daily rhythmostasis. If the Doppler ultrasound measures are: the systolic/diastolic ratio at 12.00 prior to breath-holding 3.71±0.05, after breath-holding 4.56±0.08 and at 20.00 prior to breath-holding 3.92±0.06, after breath-holding 4.74±0.09; the resistance at 12.00 prior to breath-holding 0.69±0.03, after breath-holding 0.87±0.04 and at 20.00 prior to breath-holding 0.80±0.03, after breath-holding 0.91±0.04; the pulsation index at 12.00 prior to breath-holding 1.78±0.04, after breath-holding 1.92±0.03 and at 20.00 prior to breath-holding 1.84±0.04, after breath-holding 1.97±0.04, changes in the foetus's functional status are detected and chronic foetal hypoxia is diagnosed.
EFFECT: technique enables increasing the diagnostic accuracy in chronic foetal hypoxia by measuring the functional parameters taking into account the time variations of daily rhythmostasis.
SUBSTANCE: common carotid artery (CCA) is scanned. A peak systolic blood flow velocity in the CCA and the beginning of the systolic peak to peak time, a final diastolic blood flow velocity in the CCA, systolic and diastolic CCA diameters are determined. The value K is determined by formula K=(Vs-Vd)·Dd2:[AT·(Dd2-Ds2)], wherein Vs, Vd is the peak systolic and final diastolic blood flow velocities in the CCA respectively, cm/s; Ds, Dd are systolic and diastolic CCA diameters, cm; AT is the time from the beginning of the systolic peak blood flow to its peak, s. If the value K is more than 8,500, the humoral transplanted heart rejection is diagnosed.
EFFECT: method enables increasing the early diagnostic accuracy of the humoral heart rejection by assessing the reliable diagnostic value that is a hardness of the vascular wall of the common carotid artery, and avoiding the invasive diagnostic intervention.
SUBSTANCE: technique involves transabdominal ultrasonography of jejumum and colon in longitudinal and transversal projections. The transabdominal ultrasonography is native with the patient positioned on his/her back. Visualising all the jejuneal segment involves taking intestinal loops without haustra as reference points. haustra are used as reference points for visualising the colon. pulsed Doppler velocimetry is conducted to determine a blood flow velocity in mesenterial arterial branches. A transperineal examination of the anorectal area is performed in the patient placed on his/her left side with bended knees. A sensor is placed into an anal pit directly and displaced from pubic to sacrum while scanning in two projections - longitudinal and longitudinal-oblique. The reference points are sacrum, symphysis, and anal canal. The state of a distal portion of rectal ampulla is assessed. The derived values are compared to the normal criteria. If observing any changes in the jejunum: wall thickening more than 2 mm, higher echogenicity, intestinal lumen narrowing; if observing any changes in the colon: haustra flatness, contour roughness, wall thickening more than 2.5 mm, mucosal thickness more than 1 mm, submucosal thickness more than 0.5 mm, the absence of clear layer differentiation, higher submucosal echogenicity, intestinal lumen narrowing, higher blood flow velocity in the mesenterial arterial branches more than 7.0 cm/sec; changes in adjoining organs: higher echogenicity of the greater omentum, envelopment of the jejuneal and colonic loops involved into the inflammatory process with the omentum, lengthening of the mesenterial, para-aortic lymph nodes more than 10 mm, free abdominal fluid, the changes in the anorectal area: rectal ampulla wall thickening more than 2.5 mm, higher echogenicity of perineal subcutaneous fat, anorectal fistulas and paraproctitis testify to the presence of colonic and jejuneal wall hyperplasia in the involved portions, mesenterial, para-aortic lymph node hyperplasia, reactive changes of the greater omentum, as well as the presence of a perineal inflammation, and Crohn's disease is diagnosed. The changes in the colon only: haustra flatness, smooth contours, wall thickening more than 2.5 mm, mucosal thickness more than 1 mm, submucosal thickness more than 0.5 mm, reduced clear differentiation, lower submucosal echogenicity, no intestinal lumen narrowing, higher blood flow velocity in the mesenterial arterial branches more than 7.0 cm/sec; changes in the adjoining organs: lengthened mesenterial and para-aortic lymph nodes more than 10 mm, no reactive changes of omentum, rectal ampulla wall thickening more than 2.5 mm without involving the perineal region testifies to colonic wall hyperplasia and mesenterial, para-aortic lymph nodes and enables diagnosing non-specific ulcerative colitis.
EFFECT: technique enables performing the early differential diagnosis of chronic inflammatory intestinal diseases by using the accurate qualitative and quantitative ultrasonic criteria.
SUBSTANCE: in case of unilateral cryptorchidism measured is a linear rate index of the blood flow in the medium segment of the recurrent artery of the healthy testicle Vmax1 and testicle in the cryptorchidism condition Vmax2. In case of bilateral cryptorchidism measured is the linear rate index of the blood flow in the medium segment of the recurrent artery of the right and left testicle. As Vmax2 taken is the lower index from the two measurements of the testicle blood flow. As the index of blood flow Vmax1 taken is the lower index of the age norm, constituting for children from 0 to 12 months - 1.2 cm/sec; from 1 to 3 years - 1.5 cm/sec; from 3 to 7 years - 1.8/sec, and for children above 7 years - 2.0 cm/sec. If the difference between Vmax1 and Vmax2 is larger than 25% of Vmax1 index, impairment of haemodynamics, requiring operative treatment, is diagnosed. If the difference is in the range from 15 to 25%, dynamic US-monitoring after 3, 6 and 9 months is required.
EFFECT: method makes it possible to objectify results of USE due to the clear determination of parameters of a threshold value of the blood flow index in the testicle arteries.
2 cl, 3 ex
SUBSTANCE: patient's epicardial fat thickness is measured by transthoracic echocardiography by means of a sector transducer at a frequency of 2,500 MHz on a free anterior wall of the right ventricle. Pulse Doppler imaging is performed to determine the diastolic function of the left ventricle - the E/A ratio measured as a transmitral blood flow velocity in the early diastolic filling of the left ventricle (E peak) to a transmitral blood flow velocity in a left auricular systole (A peak). If the epicardial fat thickness is from 2.7 to 4.5 mm, whereas the E/A diastolic function is less than 0.80, insulin resistance is diagnosed.
EFFECT: higher diagnostic accuracy, as well as wider number of individuals, who had the insulin resistance diagnosis.
1 tbl, 2 ex
SUBSTANCE: invention refers to medicine, namely to oncology and can be used for the prevention and early diagnosis of postmastectomy complications. The m. pectorales major et minor changes are ultrasonically assessed from the left and right in the 2-3 intercostal spaces along the midclavicular line. The muscle thickness and a degree of atrophy are determined. Phlebohaemodynamic disorders are detected by measuring a diameter and a blood flow rate with the use of thick gel pads; in v. subclavia dexter et sinister - along the clavicle between its middle and external one-thirds; in v. basilica dexter et sinister - at the border of the superior and middle one-thirds of the shoulder along the internal surface; in v. cephalica dexter et sinister - at the border of superior and middle one-thirds of the shoulder along the external surface; in v. radialis dexter et sinister - in the inferior one-third of the forearm 1.5-2 cm above the hand along the lateral surface; in v. ulnaris dexter et sinister - in the inferior one-third of the forearm 1.5-2 cm above the hand along the medial surface. An intensity of lymphostasis of the upper extremity is assessed by measuring the thickness of subcutaneous fat within the maximum intensity of oedema and phlebohaemodynamics in the vessels involved into the oedema, and of a symmetrical region of the counterlateral arm prior to and after treatment. The derived data are used to assess the functional disorders of the postmastectomy area.
EFFECT: method enables assessing the degree of structural changes of the postmastectomy area in relation to the healthy side, which makes it possible to predict technical difficulties in surgical repairs, to determine the presence of subclinical phlebohaemodynamic disorders, specifying the level of the maximum blood flow block, and evaluating the effectiveness of corrective actions at lymphostasis.
9 dwg, 2 ex
SUBSTANCE: invention relates to medical equipment, namely to means for performing cardio-pulmonary resuscitation of people. Device for control of cardio-pulmonary resuscitation contains ultrasound converter, unit of electrodes, connected via interface to processor, connected with display, memory unit, sound signaller, unit of light-diode signallers, unit of connection with central control panel unit of operation mode selection, unit of connection with the internet and, via USB interface, with unit of top level software. Device also contains colour television microcamera, connected via successively installed block of signal amplification and filtration and unit of processing and imposing alignment of images to additional processor input/output, illumination unit, pulse measurement unit, gas analyser, unit of microphones with matching unit, connected with processor and power supply unit. Pulse measurement unit and unit of electrodes are made with possibility of fixation on patient by means of fixation unit, with unit of microphones, controlled illumination unit and gas analyser being fixed on patient by means of additional fixation unit. Method of control contains stages of obtaining ultrasound echo signals and electrosignals, characterising blood flow in blood vessel, determination of blood flow characteristic by impedance of neck tissues in the process of performing cardio-pulmonary resuscitation, presentation of sound and visual information about patient/s condition. After that, current information about patient's condition is formed by television images and geometrical and colour characteristics of eye pupil and eye iris are determined, with estimation of colour and geometrical characteristics of blood vessels. Sound laryngeal signals, exhaled gas and patient's pulse are also read and analysed, light signals are used to signal about patient/s condition and patients condition is estimated basing on data of comparison of standard and current information.
EFFECT: application of invention makes it possible to extend functional possibilities, increase operation speed, immediacy and accuracy in performing cardiopulmonary resuscitation.
16 cl, 10 dwg
SUBSTANCE: method for detecting the burn wound granulation readiness for autografting involves the granulation microcirculation by laser Doppler flowmetry to calculate an average microcirculation (M, p.u.). That is combined with combining a granulation microcirculation effectiveness index (MEI). If the MEI is more than 1.6, and M is more than 3 p.u. the reparative ability of the burn wound granulation is considered to be preserved, and the granulation appears to be ready for autodermoplasty. If MEI is less than 1.6 regardless of the value M, the reparative ability of the burn wound granulation is considered to be diminished, the wound requires additional wound cleansing and granulation incision.
EFFECT: method enables providing the higher diagnostic effectiveness of the reparative ability of the tissues, selecting the autodermoplasty time, reducing the rate of transplant rejections and cutting the treatment costs and reducing the length of staying in hospital.
SUBSTANCE: microcirculation is assessed by laser Doppler flowmetry using combined functional tests - thermal postural leg test and thermal postural arm test. Both tests involve recording a microcirculation index. The derived data are saved. An average basic microcirculation from the 10th to 110th seconds is evaluated for the leg and arm tests according to the provided formulas. That is followed by calculating an average relative microcirculation Irel1 and Irel2 during the functional leg exposure according to the presented formulas. If any of the two values Irel1, Irel2 is below standard - Irel1<3.7; Irel2<3.5, the presence of microcirculatory disorders is stated in the person being tested.
EFFECT: method is accurate, simple, enables immediately detecting systemic microcirculatory disorders in the patients suffering carbohydrate metabolism disorders on the basis of available diagnostic tests and measured microcirculation parameters; using the combined functional tests involves most regulatory mechanisms that provides obtaining the reliable microcirculation information from the patients of this category.
2 cl, 2 dwg, 2 ex
SUBSTANCE: triplex scanning of the interlobular artery of the upper kidney pole is performed in clinostasis, and then within the first minute in orthostasis. The acceleration time (Ta), the total time of the blood flow during one cardiac cycle (Tt) are measured, their ratio Ta/Tt in clinostasis and orthostasis is calculated. After that the acceleration time index (ATI) is calculated by the mathematical formula. If Ta/Tt is less than 0.09 and ATI is less than 0, early affection of the kidneys, accompanied by arteriovenous shunting, is diagnosed.
EFFECT: method makes it possible to identify the group of patients requiring prophylaxis or treatment and in this way prevent the development of complications, disability retirement and mortality.
1 dwg, 3 tbl, 4 ex
SUBSTANCE: Doppler echocardiography is carried out in preoperative period on the 1-st and 10-11-th day after operation and if the value of the average calculated pressure in the pulmonary artery is higher than 22 mm Hg, development of thromboembolic complications in the lesser circulation is predicted.
EFFECT: method makes it possible to efficiently predict postoperative cardiovascular and respiratory complications in elderly and senile patients after oesophageal cancer resection.
SUBSTANCE: performed is pre- and postoperative duplex scanning of both internal carotid and vertebral arteries. The blood flow index is calculated in each artery. The derived indices are summed up to derive the intracranial blood flow index (FVIIC). The bypass blood flow index is calculated through a pathological bypass formation (FVIBP) by formula: FVIBP=FVIIC-fvin. Variations of the pre- and postoperative bypass blood flow index enable the qualitative assessment of a degree of a vascular occlusion of the pathological arteriovenous cerebral bypass.
EFFECT: method enables the qualitative and noninvasive assessment of a degree of the vascular occlusion of the intracranial pathological arteriovenous cerebral bypass, optimising the further surgical approach by evaluating a degree of the blood flow bypass re-distribution.
2 ex, 8 dwg
SUBSTANCE: invention relates to field of medicine, namely to cardiodiagnostics. Stroke volume SV00 is calculated by anthropometric parameters and compared with stroke volume SVecho evaluated by Echo-CG. If evaluated SV00 > SVecho, it indicates incompetent heart function. If evaluated SVecho ≅ SV00, conclusion about boundary state of blood circulation, which can be impaired by change of heart rate. If measured SVecho > SV00, it is concluded, that even at critical OF value, accepted in clinical practice, heart activity is evaluated as competent.
EFFECT: method makes it possible to evaluate real possibility of heart to support necessary value of minute volume of blood circulation in order to determine functional reserve of ventricle.
3 tbl, 1 ex
SUBSTANCE: invention relates to medicine, in particular to X-ray surgery. Puncture and catheterisation of peripheral vein is carried out by with diagnostic catheter in accordance with Seldinger technique. Contrast substance is introduced via it in Valsalva maneuver. Passage of contrast substance in all branches is fixed. Detected are: presence of reflux by left internal spermatic vein and its diameter, as well as signs of aortomesenterial compression of left renal vein. Additional balloon obturating double-lumen catheter is installed into the middle third of left internal spermatic vein by passed through diagnostic catheter guide and retrodrade perfusion of contrast substance into venous bed.
EFFECT: method makes it possible to determine hemodynamic type of venous outflow impairment in addition to determination of angioarchitectonics of entire venous system of left sexual gland.
2 ex, 5 dwg
SUBSTANCE: invention relates to field of medicine, in particular to anesthesiology-critical care medicine, cardiosurgery and cardiology. Assessment of central hemodynamics and analysis of echocardiography data are carried out. Decision to stop auxiliary blood circulation is taken in case of absence of negative dynamics cardiac index higher than 2.2 l/min/m2, pressure of pulmonary artery jamming 16 mm Hg by data of echocardiography. By flowmetry data: variation coefficient is 4.5-6.5%, stunting index is 0.7-1.2, blood stream reserve is 1.5-3%.
EFFECT: method makes it possible to monitor microhemodynamics indices, thus increasing efficiency of auxiliary blood circulation.
SUBSTANCE: patients' blood serum is analysed for a D-dimer level, a shunting value and a peak respiratory component amplitude. Their relative values are determined in relation to average values in healthy persons. The coefficient K is calculated by formula K=P1·P2·P3, where P1 is a value of a relative MHO level; P2 is a value of the relative D-dimer content; P3 is a relative value of a product of the shunting value and the peak respiratory component amplitude. If the coefficient exceeds 1.59±0.09, development of tromboembolic complications is predicted.
EFFECT: method extends the range of products for prediction of the tromboembolic complications in long bone fractures.
1 tbl, 3 ex
FIELD: medicine; pulmonology.
SUBSTANCE: using an echocardiography method, perform determination of average pressure in a pulmonary artery in mm hg (AvPPA, mm hg). Solve a discriminant equation: D =-4.353×AvPPA. At size of D less than (-90.66), diagnose insufficiency of a pulmonary-capillary blood flow.
EFFECT: expansion of possibility of diagnostics of inefficiency of a pulmonary-capillary blood flow in medical practice.
SUBSTANCE: ultrasonic triplex V-scanning is carried out in modes colour Doppler mapping and continuous-wave dopplerography before and after reception of 10 mg of nifedipine. Pressure gradient on descending department of aorta is measured. At reduction of pressure gradient of the descending aorta by 10 mm of mercury and more from the initial indicator expressed dilatation is diagnosed, at reduction of pressure gradient by 4-9,9 mm of mercury from the initial indicator moderated dilatation is diagnosed and at decrease not more than by 3,9 mm of mercury - absence dilatation of stenotic division of aorta.
EFFECT: possibility of estimation of condition of functional vascular reserve of stenosed division of aorta at aorta coaraction.
1 tbl, 3 ex, 8 dwg
SUBSTANCE: one should detect the side of placental predominant disposition with the help of two-dimensional ultrasound survey, fulfill dopplerometric measurement of circulatory values in left and right fetal renal arteries, estimate the difference between the values of systolodiastolic ratio of left renal artery and systolodiastolic ratio of right renal artery. In case, when this difference exceeds 20% against the value of systolodiastolic ratio of left renal artery at left-handed placental disposition one should diagnose threatening fetal state. The innovation enables to elaborate rational tactics of studying pregnancy and delivery.
EFFECT: higher accuracy of diagnostics.
FIELD: medicine, pulmonology.
SUBSTANCE: it is necessary to study initial values of functional reserve ability (FRA) of pulmonary-capillary circulation in %, average pressure value in pulmonary artery (AvPPA) in mm mercury column and daily variability of peak volumetric expiration rate (ΔPVRexp.) in % to calculate the following equation: D=+1.376·FRA-2.087·AvPPA-1.023·ΔPVRexp. At D value being above -25.71 one should predict instable flow of bronchial asthma. The innovation enables to carry out integral evaluation of functional state of pulmonary microcirculation, pressure in pulmonary artery and reactivity of respiratory tract.
EFFECT: higher efficiency and accuracy of prediction.
SUBSTANCE: method involves measuring forced exhalation volume per 1 s. Systolic pressure in pulmonary artery and ratio of maximum blood circulation speeds through tricuspid valve into diastole. Prediction is carried out on basis of value calculated from mathematical formula including measured and calculated parameters.
EFFECT: enhanced effectiveness of prediction.